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Biomedical subjects

I Epstein

Publications and source records attributed to I Epstein.

18 recordsLinked to original sources
PubMed2000

Specifying intensive case management: a multiple perspective approach.

"Intensive case management" (ICM) programs for people with serious mental illness are found widely throughout the United States. However, there is no standard definition or conceptualization of ICM. Despite these differences, ICM aspires to a set of common principles and core functions derived from the concept of continuity of care. This study attempted to identify the elements of ICM program theory by integrating information from the ICM literature with survey and focus-group data reflecting the perspectives of three distinct ICM respondent groups (researchers/administrators, program managers, and case managers). The findings suggest a strong consensus about the structural dimensions of ICM, but a moderate consensus about their operationalization. More generally, the results support viewing ICM as more "client oriented," in contrast with conventional case management programs that are more "system driven."

Case Management↗
PubMed1993

Evaluating the Mount Sinai Leadership Enhancement Program: a developmental perspective.

The principal evaluators of the Mount Sinai Leadership Exchange program used a developmental approach to evaluating the program, applying qualitative and quantitative data within the program as the program developed. Over the course of its development, evaluation, and refinement, the leadership enhancement program emerged as a vehicle for true international exchange of ideas, skills, resources, and collegiality.

Academic Medical Centers↗
PubMed1991

[Alternating rifampicin and ceftriaxone for Neisseria meningitidis eradication in contacts].

Following the occurrence of a case of meningococcal disease in a kibbutz, extensive preventive measures were instituted, consisting of alternate courses of rifampicin (10 mg/kg for 2 consecutive days) and ceftriaxone (single IM injection of 125 mg). Throughout the observation period Neisseria meningitidis was absent from oropharyngeal secretions of all those treated, but was found in those of an untreated control group. The alternate use of rifampicin and ceftriaxone should be considered for the long-term prevention of the occurrence of oropharyngeal carriers of Neisseria meningitidis.

Carrier State↗
PubMed1989

Confronting the challenge of computerization for social workers in health care settings.

Computerization and information technology will profoundly affect the work of health care social workers in the coming years. This paper reviews recent trends in information technology in health care systems and their implications for social workers. It describes recent innovations in information systems designed specifically for social workers. It concludes with a review of recent studies of utilization of computer and information systems by social workers and from these derives some of the conditions that must be created if social workers are to effectively make use of this technology.

Attitude to Computers↗
PubMed1986

Use of a combined DTP-polio vaccine in a reduced schedule.

A five-year serologic follow-up and a four-year monitoring of the polio and pertussis morbidity in an area immunized with a 2 + 1 dose schedule of a combined DTP-Po vaccine have shown that: the individual protection against polio measured by the presence of neutralizing antibody persists at a very adequate level five years after the first booster; after three years of a steady high proportion of children with pertussis antibody, a considerable drop is observed and in about 28% of individuals agglutinin levels of less than 1:20 were found five years after booster; the community protection against paralytic poliomyelitis and pertussis is satisfactory up to four years after the introduction of the program. Continuation of immunization with a 2 + 1 dose schedule at a maximal coverage and close seroepidemiologic surveillance are necessary in order to draw definite conclusions, because of the potentially strong impact of very dynamic ecological factors present in our geopolitical area upon the agent-host interrelationship.

Agglutination Tests↗
PubMed1982

Adult onset Still's disease: a cause of pyrexia of unknown origin.

A case of adult onset Still's disease is reported. A middle aged woman presented with prolonged high fever, rash, polyarthritis, leukocytosis and abnormal liver function tests. The clinical features and multisystem nature of this condition are emphasised.

Arthritis, Juvenile↗
PubMed1977

Relationship between culture density and catabolite repression of an inducible aliphatic amidase in a thermophilic bacillus.

A direct correlation between the absorbance of a thermophilic bacillus and specific amidase activity was observed, which was found to depend on the cell density of the culture rather than on the time of contact of the culture with the inducer. Dilution of high density cultures caused the specific amidase activity to decrease. Environmental factors such as pH, concentration of inducer or degree of aeration, and level of NH+4 and glutamate had no effect on amidase synthesis. The decrease in amidase activity upon dilution could not be ascribed to destruction by oxygen or by inactivation or decay. Several lines of evidence suggest that catabolite repression is responsible for the phenomenon described. Succinate-grown cultures gave a stronger dilution effect thatn glutamate-grown cells. The mutant strain E-21, relatively resistant to catabolite repression, did not show the characteristic dilution effect nor the direct correlation between absorbance and specific amidase activity.

Acetamides↗
PubMed1976

Regulatory control and function of alanine dehydrogenase from a thermophilic bacillus.

L-alanine dehydrogenase, (L-alanine:NAD+ oxidoreductase (deaminating), EC 1.4.1.1) synthesis in a thermophilic bacillus was found to be subjected to regulatory control. Addition of L- and D-alanine and L-serine to cultures growing in the presence of either succinate or pyruvate, induced an accelerated synthesis of the alanine dehydrogenase enzyme. Synthesis of the enzyme was dependent on the presence of inducer during growth and was arrested by addition of glucose. Catabolite repression by glucose was abolished by limiting the ammonium concentration during growth. The apparent Km values of the substrates involved in alanine dehydrogenase activity are as follows (M): NH4+, 4-10(-2); pyruvate, 5-10(-4); NADH, 6-10(-5); L-alanine, 3.1-10(-3) and NAD, 2-10(-4). Alanine dehydrogenase activity was measurable at temperatures below the minimal growth temperature (at 25 degrees C) and the highest activity was found at 65 degrees C; heat denaturation occurred at 80 degrees C.

Alanine↗
PubMed1976

Normal-pressure hydrocephalus due to tentorial meningioma.

Normal-pressure hydrocephalus and the associated triad of dementia, apraxic gait and urinary incontinence may be casued by various, sometimes unsuspected, lesions, usually those that block the flow of cerebrospinal fluid (CSF) around the tentorium. A 58-year-old woman with insidious onset of behaviour and gait problems had occult, normal-pressure hydrocephalus and a tentorial meningioma, resection of which produced complete recovery. This case demonstrates that a distinction must be made between the syndrome of normal-pressure hydrocephalus resulting from disturbance in CSF dynamics and the pathophysiologic features of the underlying lesion.

Brain Neoplasms↗
PubMed1975

Production and purification of the thermophilic bacteriophage TP-84.

A new procedure for production and purification of the thermophilic bacteriophage TP-84 in high yields is described. Cultures of Bacillus stearothermophilus strain 10, enriched with nutrients to obtain heavy growth and to prevent sporulation and maintained at a pH of 6.5, were infected with the phage in a 100-liter fermentor. Addition of magnesium chloride (0.01 M) and a temperature of 58-C were essential for maximal phage production. Phage (5 times 1011 infective particles/ml) was precipitated with polyethylene glycol (molecular weight 6,000) in the presence of sodium chloride and was further purified by cesium chloride density centrifugation.

Bacillus↗
PubMed1975

Purification and properties of glutamate dehydrogenase from a thermophilic bacillus.

A 250- to 300-fold purification of a nicotinamide adenine denucleotide phosphate (NADP)-dependent glutamate dehydrogenase (GDH, E.C. 1.4.1.4) with a yield of 60% from a thermophilic bacillus is described. More than one NADP-specific GDH was detected by polyacrylamide gel electrophoresis. The enzyme is of high molecular weight (approximately 2 X 10-6), similar to that of the beef and frog liver GDH. The pI of the thermophilic GDH is at pH 5.24. The enzyme is highly thermostable at the pH range of 5.8 to 9.0. The purified GDH, unlike the crude enzyme, was very labile at subzero temperatures. An unidentified factor(s) from the crude cell-free extract prevented the inactivation of the purified GDH at -70 C. Various reactants of the GDH system and D-glutamate also protected, to some extent, the enzyme from inactivation at -70 C. From the Michaelis constants for glutamate (1.1 X 10-2M), NADP (3 X 10-4M), ammonia (2.1 X 10-2M), alpha-ketoglutarate (1.3 X 10-3M), and reduced NADP (5.3 X 10-5M), it is suggested that the enzyme catalyzes in vivo the formation of glutamate from ammonia and alpha-ketoglutarate. The amination of alpha-ketoglutarate and deamination of glutamate by the thermophilic GDH are optimal at the pH values of 7.2 and 8.4, respectively.

Acetone↗
PubMed1969

Prototrophic thermophilic bacillus: isolation, properties, and kinetics of growth.

A thermophilic bacillus (minimal growth temperature 41 C, optimal 55 to 58 C, and maximal 65 C) was isolated from a manure pile. It is very similar to Bacillus stearothermophilus, but it differs in its inability to hydrolyze starch. The thermophilic isolate is a prototroph which grows in a minimal medium consisting of glucose, ammonium salt, phosphate buffer, and inorganic salts. At all temperatures studied (low to high), the same minimal nutritional requirements prevailed. The Arrhenius constant for growth was found to be 15,000 and 13,500 cal/mole in the minimal and rich media, respectively.

Bacillus↗
PubMed1969

Intracellular protein breakdown in a thermophile.

Protein breakdown of 5 to 7% per hr was found in nitrogen-starved cells of an unclassified prototrophic thermophilic bacillus; a similar protein-breakdown rate (6.5% per hr) was found in resting cells of Escherichia coli. In the thermophile, the rate of protein breakdown was markedly influenced by the temperature; it was maximal between 45 and 55 C, and it decreased considerably at 35 and 75 C, temperatures which are only slightly below or above the minimal and maximal growth temperatures. Growing cultures of the thermophile showed little, if any, protein breakdown, a finding similar to that of others with E. coli.

Bacillus↗
PubMedDate not supplied

Epidemiology of rubella and congenital rubella infection in Israel, a country with a selective immunization program.

A rubella immunization program directed at girls aged 12 years started in Israel in 1973, and its extension in 1980 to women of childbearing age had produced by 1983 several changes in the epidemiologic pattern of rubella infection in women of childbearing age and in the risk of congenital rubella: a 55%-77% decline in the incidence of the disease in the 15-44-year age group; a progressive reduction in the rate of seronegativity among women from greater than 20% to less than 10%; a risk of infection during pregnancy and a percentage of abortions associated with rubella infection in the 1983 outbreak that were one-twelfth and one-tenth, respectively, the values associated with the 1978 and 1979 epidemics; and an evident decrease in the frequency of cases of congenital rubella, as detected by either passive or active surveillance. It is predicted that of the women who will be pregnant in 1985, 98.2% and 94.3% of those in the 18-23 year and 24-44 year age groups, respectively, will be immune by the end of 1984.

Adolescent↗